Radiofrequency ablation of basivertebral and sinuvertebral nerves for chronic discogenic low back pain: a systematic review and meta-analysis.
Systematic Review
Radiofrequency ablation (RFA) of the basivertebral and sinuvertebral nerve is a relatively new intervention for patients with chronic discogenic low back pain. It aims to ablate the irritated nerve endings to improve pain control and disability. This meta-analysis includes prospective single and double-arm studies that determine if RFA is effective in improving chronic low back pain and disability for patients with degenerative spinal discs who have not yet required surgical decompression. The outcomes of interest were comprised of commonly used patient-reported outcomes, which included the Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) scores. Forest plots were generated to report associations as well as funnel plots to report the risk of publication bias. The meta-analysis included 429 patients from five eligible studies, comprising two randomized controlled trials and three prospective single-arm trials. A total of 280 patients underwent RFA whereas 149 served as controls. The baseline scores in the single-arm trials served as the outcomes of their control group. The RFA group (n = 280) had significantly lower ODI scores (mean difference = - 28.08; 95% CI: [- 43.53, - 12.63]) than the control group (n = 240). Similarly, the RFA group (n = 279) had significantly lower VAS scores (mean difference = - 3.16; 95% CI: [- 5.02, - 1.31]) than the control group (n = 238). Our study demonstrates RFA as a promising intervention for chronic discogenic low back pain, noting significant improvements in pain control and disability. Although not intended to substitute surgical decompression, it can serve as a better alternative to other non-operative therapies in patients who do not require surgical management. Clinical trial number: not applicable.
